Medigap Insurance

When the time comes for you or a loved one to begin learning about Medigap insurance, at first glance it can seem like a very confusing endeavor. Whether you or a family member is first entering the Medicare system and learning about Medicare Supplemental insurance, or you are simply shopping for a lower premium on your current coverage, it’s extremely important to know some of the basics so you not only get the right plan but also do not pay too much for it.

Medicare Supplements offer additional coverage over regular Medicare and pay most or all of the gaps in coverage. This applies to people not only turning 65 who are eligible for Medicare, but also those who are on Social Security disability and qualify for Medicare Part A and Part B.

If you are on Medicare and do not have one of the many Medigap Plans available you are responsible for paying what Medicare does not, and in many cases these costs can add up very quickly. To see why a supplement is important you must first understand what medical bills are and are not paid by Medicare.

Medigap Insurance Basics

If you are turning age 65 in the United States and you have paid into Medicare to qualify, you are eligible for Part A and Part B (as well as Part D) Medicare. This is often referred to as “Original Medicare”.

Medicare Part A (Hospital Coverage) and it’s Benefits

  • Room and Board when admitted to the hospital
  • Care while staying in a skilled nursing facility
  • Hospice Care
  • Eligible home health care coverage

With Medicare Part A you must pay a deductible of over $1150 if you are admitted to the hospital. If you leave for 60 days or more and are admitted again you are required to pay this again. This is called a benefit period for Part A.

With no Medicare Supplement you are also required to pay any hospital coinsurance if you are in over 60 days, as well as any skilled nursing facility coinsurance. With the right Medigap Plan you will not have to pay any of this out-of-pocket.

Medicare Part B (Services Provided by Doctors)

  • Covers all eligible by Medicare Doctor’s services
  • Any hospital services on an outpatient basis
  • Ambulance Service if deemed necessary
  • Some outpatient prescription medications

For Medicare Part B you must pay an annual deductible, after which you are open to paying 20% of all your doctor’s bills. This, along with the other gaps in Medicare are why many people elect to enroll in a Medicare Supplement plan.

So while Part A and Part B Medicare both have fairly comprehensive coverage, they do not pay for all expenses. These expenses that you are responsible for include things like copays, deductibles, coinsurance, and excess charges from Medicare Part B if applicable.

Many of the more popular Medicare Supplement Plans pay most if not all of those gaps in Medicare. One important fact to remember is that these plans are standardized by the government and regardless of which carrier you decide to get your Medigap insurance from, they all have the exact same plans. The premiums for these plans often varies greatly depending on the insurance company though.

Choosing the Best Medigap Plan

When it comes to Medigap Plans, each policy has a letter assigned to it and they all have slightly different coverage. There are currently 10 Medicare Supplement Plans available and several different companies that offer these policies.

Many people understand that companies such as Mutual of Omaha or Blue Cross offer this coverage, and you may not have heard of some of the other many companies that offer Medicare Supplemental Insurance. Considering that many insurance companies may specialize in only Medigap Insurance and you are new to Medicare it is only reasonable that you might not recognize some of their names. This does not mean you should simply go with the “Big named” company, as you could end up paying substantially more for the exact same coverage.

We help our clients to shop the market every year to make sure you are paying the lowest premium for the best coverage that you qualify for.

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Are You Eligible?

Anyone who has paid into Medicare by way of payroll taxes for at least 10 years is eligible for Medicare Part A and Part B upon turning 65. There is what is called an Open Enrollment period at this time and beneficiaries have 6 months in which they may apply for a Medigap Policy and cannot be turned down for any coverage regardless of any pre-existing conditions they might have. Therefore it is extremely important not to miss this period for those individuals.

Many companies that offer Medigap Insurance plans will allow you to enroll from 3-6 months prior to your Part A and Part B effective dates and lock in your rate. This applies to anyone under the age of 65 who is eligible for Social Security Disability and meets Medicare’s guidelines for their effective date of coverage.

Coming off Employer Health Insurance

Many people are over the age of 65 and still working and receiving health insurance benefits from their employer. While Medicare Part A goes into effect when they turn 65, they may hold off on obtaining Part B Medicare until they retire or their employer no longer offers health insurance. Even if they are over the age of 65 they will still receive the same Open Enrollment period for 6 months from the time their Part B Medicare goes into effect. In this time they may apply for and receive Medicare Supplemental Insurance without having to go through medical underwriting.

For anyone who already has Part B Medicare and is retiring and leaving their group health insurance, they may likely qualify for a period of “Guaranteed Issue” of 63 days from the day their employer’s coverage ends. The rules for this may vary by insurance carrier and state, therefore please contact us to see what you qualify for.

The Right Way to Shop for Medigap Insurance

Considering that Medicare Supplement insurance companies all having different premiums for the exact same coverage, it’s extremely important to have a qualified advisor help walk you through the process of purchasing Medicare Supplement coverage. An experienced agent can shop the top companies and their rates to make sure you don’t over pay and you’re getting the very best plan for your needs.

Our job is to make sure you completely understand Medicare and the coverage that you’ll be receiving with your Medigap Plan, and we’ll watch the rate increases every year as well to keep you saving money. Best of all you won’t pay any extra to get help from one of our experienced Medigap Insurance Agents.

 

 

Medigapv.com is provided solely for informational purposes and estimations of policy rates regarding Medigap Insurance, and is not connected in any way with  the Federal Medicare Program, the Centers for Medicare and Medicaid Services, The Social Security Administration or any government organization.